OSHA Long Term Care Worker Protection Program: Hazard Recognition and Strategies for Safe Working Surfaces

1. OSHA Long Term Care Worker Protection Program

2. Describe OSHA general requirements. • Recognize common hazards in long term care related to walking and working surfaces. • Discuss specific strategies to eliminate or minimize these hazards.

3. 1910.22: Applies to all permanent places of employment, except where domestic, mining, or agricultural work is performed. • Standards: * Housekeeping * Aisles and passageways * Covers and guiderails * Floor loading protection

4. All places of employment shall be kept clean and orderly and in a sanitary condition. • Workrooms clean & dry. • Platforms, mats, or other dry standing places for wet processes.

5. Floors shall be kept free from protruding nails, splinters, holes, or loose boards (tiles loose, holes in flooring).

6. Sufficient safe clearance maintained where mechanical handling equipment is used. • Aisles and passageways shall be kept clear and in good repair. • No obstruction across or in aisles that could create a hazard.

7. Permanent aisles and passageways shall be appropriately marked.

8. Floor load ratings must be posted, in a conspicuous place to which they relate.

9. Floor Opening: 12” or more in its least dimension, in a floor, platform, or yard, through which persons may fall. • Floor Hole: less than 12” but more than 1”, through which materials but not persons may fall. • Wall Opening: at least 30” high and 18” wide in any wall or partition through which persons may fall. Standards specific to protective devices that must be used – CFR 1910.23

10. Every stairway floor opening shall be guarded by a standard railing. • Railings shall be provided on all exposed sides (except at entrance to stairway).

11. (1)Every wall opening from which there is a drop of more than 4 feet shall be guarded by one of the following: • (i)Rail, roller, picket fence, half door, or equivalent barrier. 18" Wall Opening W x H 30" 4' Drop

12. Every open-sided floor or platform 4 feet or more shall be guarded on all open sides except where there is entrance to a ramp, stairway, or fixed ladder.

13. Every flight of stairs having four or more risers shall be equipped with standard stair railings or standard handrails.

14. A standard railing consists of top rail, intermediate rail, and posts. • Have a vertical height of 42 inches nominal from upper surface of top rail to floor. • The top rail smooth-surfaced. • The ends of the rails shall not constitute a projection hazard.

15. 30" - 34" A stair railing shall be not more than 34 inches nor less than 30 inches from upper surface of top rail to surface of tread in line with face of riser at forward edge of tread.

16. (b)(i)All wood parts free from sharp edges and splinters; • (b)(i)Visually acceptable • (c)(2)Stepladders 20' max. • (c)(3)(ii)(a)Single ladders 30' max.

17. No ladder should be used to gain access to a roof unless the top of the ladder shall extend at least 3 ft above the point of support, at eave, gutter, or roofline.

18. Portable Metal Ladders 1910.26 • (a)(1)Designed to produce a ladder without structural defects or accident hazards such as sharp edges, burrs, etc. • (a)(1)(v)Slip resistant rungs.

19. Portable Metal Ladders 1910.26 • (a)(1)(v)Rungs corrugated or knurled. • (c)(2)(iv)Ladders must be maintained in good usable condition at all times. • (c)(2)(vii)Ladders having defects are to be marked and taken out of service until repaired by either maintenance department or the manufacturer.

20. Use of Ladders 1910.26(c) • (3)(v)When ascending or descending the climber must face the ladder.

21. Housekeeping concerns • Corridors and aisles clean, with no obstructions • Use of objects to reach high areas….ladders?

22. Direct Patient Care environments: * Wet floors – response; not always avoidable occurrences. * Hallways – materials, furniture, supplies. * Space in the patient care rooms. * Supply areas – storage, aisle and working space. * Work surfaces – desk tops, supply room counters. • Support Environments: * Kitchen preparation areas – floors, prep tables, trays, eating surfaces, etc. * Engineering/Maintenance areas. * Supply/Materials.

23. Raise awareness of the importance of all working surfaces being kept clean. • Water spills on the floor…..what is the response we need from all employees? • Corridors and aisles…..can we improve the passageways?

24. Aisles/Corridors

25. Aisles/Corridors

26. Slips, trips, and falls. • Fractured wrists, arms, legs. • Sprains. • Back injuries. • Delays in providing care. • None of these are good for employees or patients!

27. Hallway clutter, disruption, difficult passageways. • Ability of staff to move about storage/work rooms with ease. • Can all items be easily reached in storage areas/supply rooms? • Is everyone aware of potential hazards? • Working with fluids.

28. Strategies • Clean up spills immediately. If unable to do so, then report the spill promptly. • Use “wet floor” signs when the floor is wet; take them down when floor is dry. • Clean one side of a hallway at a time leaving the other side dry for traffic. • Use slip resistant floor coatings in kitchens and bathing facilities.

29. Strategies • Use sturdy shoes with good traction. • Use handrails when walking on stairs. • Do not use aisles/corridors for storage. • Watch for proper placement of electrical cords. • Repair or replace damaged carpet or floor tiles.

30. Strategies • Provide cleaning materials for staff to use at work stations, on shared phones/computers, med stations/carts. • Cleaning over bed tables after each use. • No food or drink in an area that could have infectious materials (specimens, etc). • Careful management of dirty linens. • Waste baskets emptied before they get full. • Report any broken tile or flooring that could cause a fall.

31. Make everyone more aware of the safety of the walking and working surfaces in their work environment. • Engage everyone in keeping areas clean and uncluttered. • Help patients and families to report any spill or other hazard. • Strive to eliminate or diminish the hazard quickly!

32. Importance of employee awareness of hazards and appropriate actions. • Keeping all work areas ________and__________. • Aisles and passageways _________________. • Keep exits free from ____________________. • Spills need to be ________ and _______ ____. • Use ________ ______ for wet floor areas.

33. What’s wrong with this picture?

34. Part of our on-going training. • Reminders help. • Role models. • Employees need to report hazards, take appropriate actions. • Safety is important for everyone!

35. When it comes to the Occupational Safety and Health regulations, including Walking & Working Surfaces: Think Safety, not just Compliance!